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Review

Primary adrenal insufficiency in adults: When to suspect, how to diagnose and manage

Michelle D. Lundholm, MD, Jayachidambaram Ambalavanan, MD and Pratibha PR Rao, MD, MPH
Cleveland Clinic Journal of Medicine September 2024, 91 (9) 553-562; DOI: https://doi.org/10.3949/ccjm.91a.23072
Michelle D. Lundholm
Associate Staff, Department of Endocrinology, Diabetes, and Metabolism, Cleveland Clinic, Cleveland, OH
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  • For correspondence: [email protected]
Jayachidambaram Ambalavanan
Adult Endocrinologist, Department of Endocrinology, Diabetes, and Metabolism, Maine Medical Center, Maine Health, Sarborough, ME
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Pratibha PR Rao
Medical Director Adrenal Center, Department of Endocrinology, Diabetes, and Metabolism, Cleveland Clinic, Cleveland, OH; Clinical Assistant Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH
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  • Release date: September 1, 2024
  • Expiration date: August 31, 2025
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ABSTRACT

Primary adrenal insufficiency is rare but serious; it puts patients at risk of acute decompensation and adrenal crisis due to insufficient cortisol and aldosterone production. Further, its diagnosis is often delayed, or it is mistaken for secondary adrenal insufficiency, which can have life-threatening consequences. Early recognition and appropriate treatment can greatly improve patient outcomes and quality of life.

  • Copyright © 2024 The Cleveland Clinic Foundation. All Rights Reserved.
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  1. Michelle D. Lundholm, MD⇑
  1. Associate Staff, Department of Endocrinology, Diabetes, and Metabolism, Cleveland Clinic, Cleveland, OH
  1. Address:
    Michelle D. Lundholm, MD, Department of Endocrinology, Diabetes, and Metabolism, F20, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195; lundholmmichelle{at}gmail.com
  1. Jayachidambaram Ambalavanan, MD
  1. Adult Endocrinologist, Department of Endocrinology, Diabetes, and Metabolism, Maine Medical Center, Maine Health, Sarborough, ME
  1. 19084-pratibha-raoPratibha PR Rao, MD, MPH
  1. Medical Director Adrenal Center, Department of Endocrinology, Diabetes, and Metabolism, Cleveland Clinic, Cleveland, OH; Clinical Assistant Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH

ABSTRACT

Primary adrenal insufficiency is rare but serious; it puts patients at risk of acute decompensation and adrenal crisis due to insufficient cortisol and aldosterone production. Further, its diagnosis is often delayed, or it is mistaken for secondary adrenal insufficiency, which can have life-threatening consequences. Early recognition and appropriate treatment can greatly improve patient outcomes and quality of life.

  • Copyright © 2024 The Cleveland Clinic Foundation. All Rights Reserved.
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Cleveland Clinic Journal of Medicine: 91 (9)
Cleveland Clinic Journal of Medicine
Vol. 91, Issue 9
1 Sep 2024
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Primary adrenal insufficiency in adults: When to suspect, how to diagnose and manage
Michelle D. Lundholm, Jayachidambaram Ambalavanan, Pratibha PR Rao
Cleveland Clinic Journal of Medicine Sep 2024, 91 (9) 553-562; DOI: 10.3949/ccjm.91a.23072

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Primary adrenal insufficiency in adults: When to suspect, how to diagnose and manage
Michelle D. Lundholm, Jayachidambaram Ambalavanan, Pratibha PR Rao
Cleveland Clinic Journal of Medicine Sep 2024, 91 (9) 553-562; DOI: 10.3949/ccjm.91a.23072
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  • Article
    • ABSTRACT
    • PRIMARY VS SECONDARY ADRENAL INSUFFICIENCY
    • DIAGNOSIS IS OFTEN DELAYED
    • WHEN TO SUSPECT PRIMARY ADRENAL INSUFFICIENCY
    • BIOCHEMICAL EVALUATION
    • CAUSES OF PRIMARY ADRENAL INSUFFICIENCY
    • HOW TO TREAT PRIMARY ADRENAL INSUFFICIENCY
    • DISCLOSURES
    • REFERENCES
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